Allergies Worse at Night: Causes and Treatment

Turns out, it’s actually pretty common for people with allergies to have their worst watering, itching, and congestion at bedtime, says Jessica Hui, MD, a pediatric allergist and immunologist at National Jewish Health in Denver, Colorado. The reasons why have to do with a few different factors, including your indoor environment and your body’s natural rhythm, she adds.

Here’s a look at the top causes of nighttime allergies, and how to treat symptoms to get a better night’s rest.

Related Stories

6 reasons your allergies are so much worse at night

There are a few reasons why you might have nighttime allergies—many of which can be fixed with simple lifestyle changes.

1. You’re tracking pollen inside

You might still be exposed to allergens like pollen when you come inside at the end of the day, Dr. Hui explains. The stuff can easily cling to your shoes, clothes, hair, or your pet’s fur (if they’ve been outside) unless you make a dedicated effort to wash it off (like changing your clothes or showering when you come in). Pollen can also waft into the air if you’ve had the windows open. This may be why you find yourself sneezing at night in bed.

2. There’s dust in your room

The majority of our exposure to dust mites happens during sleep, notes the American Lung Association. That’s because the microscopic bugs accumulate in blankets, pillows, sheets, mattresses, carpets, and curtains (especially when they haven’t been washed in a while). So if you’ve got a dust allergy, your symptoms could start going haywire when you get into bed.

3. You’re using a humidifier

Humidifiers can be a godsend during the cold, dry winter months. But if you have a dust or mold allergy, running one in your bedroom might be making your symptoms worse, Dr. Hui says. That’s because high levels of moisture in the air—think above 50 percent humidity —can set the stage for dust mites and mold spores, according to the American Academy of Allergy Asthma & Immunology (AAAAI). If your seasonal allergies are worse at night, consider turning off the humidifier for a few nights and see how you feel.

4. You’re sleeping near a pet

No shade to your furry friend, but dog allergies can be worse at night. This is especially true if you let your dog (or cat) in bed with you, or even let them hang out in your room. “Pet dander is sticky and small, so it remains airborne longer and also stays on not only your bedding but also curtains, walls, and other surfaces of the bedroom,” Dr. Hui says.

Your pet’s fur might be the culprit even if you’re not allergic to their dander, BTW. Dogs and cats that spend time outdoors can trap pollen, ragweed, and other outdoor allergens in their fur, Dr. Hui says. That stuff then gets spread around your bed when they dive into your sheets, and deposited right into your nasal passages when the two of you snuggle up. So if you wake up sneezing in the middle of the night, chances are your dog or cat’s nearby.

5. It’s your circadian rhythm

Fun fact: Your body’s internal clock is actually primed for your allergy symptoms to be worse overnight and first thing in the morning, according to a February 2015 review in the European Journal of Allergy and Clinical Immunology¹. “There is some thought that cortisol levels are lower at night which changes how the body responds to allergens,” Dr. Hui says.

6. It’s your body position

Sleeping with allergies can be tough. Just lying down can worsen symptoms like congestion and post-nasal drip, Dr. Hui explains. With less help from gravity, it’s easier for mucus to pool up in your nose or throat and make you uncomfortable. This is why the best position to sleep with allergies might be on your side, or with your head elevated by a wedge pillow.

Symptoms of allergies at night

Nighttime allergy symptoms are similar to what you might feel during the day, just more intense. According to Yale Medicine, this may include:

• Runny nose
• Stuffy nose
• Itchy nose
• Sneezing
• Itching
• Watering eyes
• Coughing
• Fatigue

If you have asthma, allergies can also trigger wheezing or shortness of breath, which should be treated with an inhaler or other asthma medication.

How to relieve allergies that are worse at night

There are lots of things you can do to improve the bedtime allergy situation. Your action plan may include the following:

• Take your allergy meds at night. Dosing before bed will help control your symptoms as you sleep and first thing in the morning, according to the National Library of Medicine. If you take a once-daily med, be sure to be consistent for the best possible results, Dr. Hui adds.
• Keep as much pollen out as possible. Leave your shoes outside, change your clothes when you come in, and take a shower to rinse off any pollen residue. Try to keep the windows shut, too, Dr. Hui recommends.
• Clean your room regularly to prevent dust buildup. If you have carpets, vacuum your bedroom and other living areas with a vacuum cleaner that has a small-particle or HEPA filter once a week. Mop hard floors, wipe down surfaces, and wash area rugs with the same frequency. If you have curtains, try to wash them once a season, per the AAAI.
• Wash your sheets once a week. Use hot water—think 130 degrees Fahrenheit or hotter—to kill off dust mites, recommends the AAAI.
• Address the humidity situation. If you run a humidifier, you can use a device called a hygrometer to make sure your indoor humidity is below 50 percent. (You can get one at the hardware store or on Amazon for around $10.) You should also aim to clean your humidifier and change its filter regularly to prevent mold buildup in the unit. The humidifier’s manual should have cleaning instructions.
• Keep your pet out of your room. We know this is a tough one, but keeping your pet away from your sleeping quarters (including during the day) is the best way to prevent dander and outdoor allergens from affecting you, Dr. Hui says.
• Elevate your head. Propping your head up with a couple extra pillows makes it a little easier for congestion-causing mucus to drain. This may be especially helpful if you feel like you have difficulty breathing at night from allergies.

Can you prevent allergies from getting worse at night?

Being proactive about managing your allergies can help lower your nighttime symptom load. “Sometimes it’s the buildup of allergen exposures throughout the daytime that culminate in peak symptoms at the end of the day,” Dr. Hui explains.

Taking your meds regularly and limiting your exposure to the allergen as much as possible throughout the day can make a difference. Some other prevention tips include the following, per the Mayo Clinic:

• Stay indoors when pollen counts are high. Early morning and dry, windy days tend to be the worst.
• Change your clothes and take a shower when you come inside.
• Limit or avoid outdoor tasks that expose you to allergens, like mowing the lawn or gardening. When you do have to do outdoor work, wear a face mask.
• Run the air conditioning instead of leaving the windows open.
• Change your air filters regularly if you have forced heating or air conditioning.

When to see a doctor

Seasonal allergy symptoms are manageable with the right treatment plan. So if you’re having trouble handling your symptoms on your own, let your doctor know. “Being evaluated will be helpful. An allergy doctor will ask questions to then tailor recommendations for your needs,” Dr. Hui says.

FAQ

What is the best position to sleep with allergies?

Personal preference plays a big role here, of course. But in general, lying on your side with a couple pillows to prop up your head will probably be the most comfortable, because it encourages mucus to drip down your throat instead of pooling up in your nasal cavity, recommend experts at Columbia University Irving Medical Center.

What medicine is good for nighttime allergies?

Any over-the-counter allergy medications (like Zyrtec, Allegra, or Claritin) can help you manage your symptoms during the day or night. While some antihistamines (like Benadryl), are more likely to cause drowsiness, you should let your doctor know if you’re relying on these meds to help you sleep, Dr. Hui says. It’s possible that you have an underlying sleep issue apart from your allergies that’s making it harder to doze off.

Can I take Benadryl every night for allergies?

While this may be tempting, it’s probably not the best idea. It’s fine to take an antihistamine like Benadryl to fall asleep once in a while, but you can develop a tolerance to it if you take it every night. This med can also cause side effects like daytime drowsiness, dizziness, dry mouth, ringing in your ears, nausea, abdominal pain, balance and coordination issues, mucus buildup in the lungs, and even rapid heart rate, per the Mayo Clinic. If you’re looking for a better long-term treatment, reach out to your doctor for advice.